The Antimicrobial Susceptibility of Porphyromonas gingivalis: Genetic Repertoire, Global Phenotype, and Review of the Literature

Abstract

The in vitro antimicrobial susceptibility of 29 strains of the major periodontal pathogen Porphyromonas gingivalis and three P. gulae (as an ancestor) to nine antibiotics (amoxicillin, amoxicillin/clavulanate, clindamycin, metronidazole, moxifloxacin, doxycycline, azithromycin, imipenem, and cefoxitin) was evaluated by E-testing of minimal inhibitory concentration (MIC) according to international standards. The results were compared with 16 international studies reporting MICs from 1993 until recently. In addition, 77 currently available P. gingivalis genomes were screened for antimicrobial resistance genes. E-testing revealed a 100% sensitivity of P. gingivalis and P. gulae to all antibiotics. This was independent of the isolation year (1970 until 2021) or region, including rural areas in Indonesia and Africa. Regarding studies worldwide (675 strains), several method varieties regarding medium, McFarland inoculation standards (0.5–2) and incubation time (48–168 h) were used for MIC-testing. Overall, no resistances have been reported for amoxicillin + clavulanate, cefoxitin, and imipenem. Few strains showed intermediate susceptibility or resistance to amoxicillin and metronidazole, with the latter needing both confirmation and attention. The only antibiotics which might fail in the treatment of P. gingivalis-associated mixed anaerobic infections are clindamycin, macrolides, and tetracyclines, corresponding to the resistance genes erm(B), erm(F), and tet(Q) detected in our study here, as well as fluoroquinolones. Periodical antibiotic susceptibility testing is necessary to determine the efficacy of antimicrobial agents and to optimize antibiotic stewardship.

Selective Inhibition of the Periodontal Pathogen Porphyromonas gingivalis by Third-Generation Zafirlukast Derivatives

“…Additionally, we used Tet as a positive control as it is a common antibiotic used for the treatment of periodontitis and it has been shown to be active against many P. gingivalis species within the range of 2.81 μM . It is also important to note that the second- and third-generation ZAF derivatives were tested in preliminary percent growth inhibition assays with a wide range of concentrations to determine their initial activity to be used in future studies and further investigation for lead optimization outside the scope of this preliminary investigation.…”

“…19 Additionally, we used Tet as a positive control as it is a common antibiotic used for the treatment of periodontitis and it has been shown to be active against many P. gingivalis species within the range of 2.81 μM. 21 It is also important to note that the second-and third-generation ZAF derivatives were tested in preliminary percent growth inhibition assays with a wide range of concentrations to determine their initial activity to be used in future studies and further investigation for lead optimization outside the scope of this preliminary investigation. As these compounds were not previously tested against this specific strain of P. gingivalis, to test the ability of the ZAF derivatives to inhibit P. gingivalis growth, a wide range (1−100 μM) of concentrations were used to determine their level of potency against planktonic oral bacterial species.…”

Porphyromonas gingivalis Virulence Factors and Clinical Significance in Periodontal Disease and Coronary Artery Diseases

“…It is also present in treating oral infections caused by P. gingivalis . According to available data, it is more pronounced in biofilms [ 118 ]. The sensitivity to antimicrobial agents in biofilm is 1000 times less than in planktonic cells [ 119 ].…”

Nanoparticles of Liquid Smoke Rice Husk Inhibit Porphyromonas gingivalis

“…2 Periodontitis treatment performed includes controlling the accumulation of plaque in the oral cavity and also root canal treatment to eliminate bacteria that cause infection 3 Administration of antibiotics is used as a support in reducing the number of colonies of Porphyromonas gingivalis, but it should be noted that antibiotics can cause side effects that can reduce drug concentrations in target cells and a resistance to bacteria due to improper use and not as recommended, it will cause bacteria to grow, easily adaptable and immune to antibiotics. 4…”

“…2 Periodontitis treatment performed includes controlling the accumulation of plaque in the oral cavity and also root canal treatment to eliminate bacteria that cause infection 3 Administration of antibiotics is used as a support in reducing the number of colonies of Porphyromonas gingivalis, but it should be noted that antibiotics can cause side effects that can reduce drug concentrations in target cells and a resistance to bacteria due to improper use and not as recommended, it will cause bacteria to grow, easily adaptable and immune to antibiotics. 4 The latest research is growing related to the processing of natural ingredients as a suitable alternative as an antimicrobial that is safer for consumption in the long term. 5 One of the developments of liquid smoke rice husks the health sector is as an antimicrobial agent; this is supported by the stimulation of a healing process in the oral mucosa against several bacteria.…”